Clinical trials of adult acute nonlymphocytic leukemia: evidence of progress

Abstract

It is widely held that major progress has been made during the past decade in the medical management of acute nonlymphocytic leukemia (ANLL) and that with the regimens of the late 1970s some 15%-20% of patients now achieve complete remission (CR) and do not relapse ( 18, 2 1, 28, 3 1, 32, 43, 45, 49). H owever, in a previous review on this subject covering studies published in the late 1960s through 1979, we were not able to corroborate this (4). The current review covers progress since 1979, examining recent advances in remission-induction, consolidation and maintenance regimens. Unlike our last review the present one is cautiously encouraging and suggests ANLL is yielding to the intervention of the medical oncologist. As in the previous review only clinical studies consisting of 15 or more patients with ANLL have been examined and papers published from 1980-83 are the focus of the present review. Except for several abstracts dealing with consolidation or selected for data on high remission rates with prolonged survival following short-term chemotherapy, only full manuscripts were considered. When available, the following data were extracted: (i) number of patients treated, (ii) drugs used for remission-induction, consolidation and maintenance, (iii) CR rate, (iv) median duration of remission, (v) median survival of all patients, and (vi) median survival of those who achieved a CR. In addition, an attempt was made to identify the percentage of patients who entered CR and who were alive and free of disease 3, 4, and 5 years later.